Journal of anesthesia · 2025
Feasibility of a home-based perianesthesia nurse-led remote multimodal prehabilitation program using smartphone applications for older adults undergoing surgery.
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Sato Mariko, Ida Mitsuru, Kawaguchi Masahiko
Аннотация
PURPOSE: To assess the feasibility of a home-based perianesthesia nurse-led remote multimodal prehabilitation program with smartphone applications for older patients undergoing surgery.
METHODS: In this single-arm, prospective interventional study, patients aged ≥ 65 years scheduled for surgery under general anesthesia at a Japanese tertiary hospital were enrolled. Eligible patients were those undergoing various surgical procedures, able to use a smartphone, and with at least 14 days between the surgical decision and the operation. Exclusion criteria were based on the discontinuation criteria for cancer rehabilitation. The intervention was entirely home-based and consisted of nutritional therapy, exercise therapy, and cognitive training. The primary outcome was the feasibility of a remotely implemented multimodal prehabilitation program, assessed by participation, adherence, and completion rates. Secondary outcomes included the incidence of postoperative complications and changes in disability during the perioperative period.
RESULTS: Among the 100 eligible patients, the participation rate was 50% (50/100), with a 92% completion rate (46/50). Adherence rates were 67.4% for nutritional therapy; 19.6% for achieving 5000 steps per day and 56.5% for achieving 2000 steps per day in exercise therapy; and 78.3% for squats, 78.3% for heel raises, and 60.9% for front lunges in resistance training. In cognitive training, 2.1% engaged in training games for at least 30 min per day, whereas 34.8% did so for at least 15 min per day. No adverse events occurred.
CONCLUSION: This home-based perianesthesia nurse-led remote multimodal prehabilitation program with smartphone applications was safely implemented for older patients under the leadership of perianesthesia nurses.
METHODS: In this single-arm, prospective interventional study, patients aged ≥ 65 years scheduled for surgery under general anesthesia at a Japanese tertiary hospital were enrolled. Eligible patients were those undergoing various surgical procedures, able to use a smartphone, and with at least 14 days between the surgical decision and the operation. Exclusion criteria were based on the discontinuation criteria for cancer rehabilitation. The intervention was entirely home-based and consisted of nutritional therapy, exercise therapy, and cognitive training. The primary outcome was the feasibility of a remotely implemented multimodal prehabilitation program, assessed by participation, adherence, and completion rates. Secondary outcomes included the incidence of postoperative complications and changes in disability during the perioperative period.
RESULTS: Among the 100 eligible patients, the participation rate was 50% (50/100), with a 92% completion rate (46/50). Adherence rates were 67.4% for nutritional therapy; 19.6% for achieving 5000 steps per day and 56.5% for achieving 2000 steps per day in exercise therapy; and 78.3% for squats, 78.3% for heel raises, and 60.9% for front lunges in resistance training. In cognitive training, 2.1% engaged in training games for at least 30 min per day, whereas 34.8% did so for at least 15 min per day. No adverse events occurred.
CONCLUSION: This home-based perianesthesia nurse-led remote multimodal prehabilitation program with smartphone applications was safely implemented for older patients under the leadership of perianesthesia nurses.